The association between diabetes mellitus and postoperative cognitive dysfunction: a systematic review and meta-analysis

医学 术后认知功能障碍 糖尿病 科克伦图书馆 入射(几何) 相对风险 内科学 荟萃分析 病因学 认知 精神科 内分泌学 置信区间 物理 光学
作者
Hongbo Liu,Jiali Chen,Jitao Ling,Yuting Wu,Pingping Yang,Xiao Liu,Jianping Liu,Deju Zhang,Xiaoping Yin,Peng Yu,Jing Zhang
出处
期刊:International Journal of Surgery [Elsevier]
卷期号:111 (3): 2633-2650 被引量:6
标识
DOI:10.1097/js9.0000000000002156
摘要

Background: Postoperative cognitive dysfunction (POCD) is a typical consequence following surgery, particularly in cardiac surgeries. Despite its high incidence, the underlying etiology remains unclear. While diabetes mellitus (DM) has been associated with cognitive impairment, its specific function in POCD development remains unidentified. This study aims to evaluate the connection between DM and the risk of POCD. Methods: We conducted a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library databases for studies of DM and risk with POCD, collecting data up to 14 September 2023. We assessed publication bias, heterogeneity, and study quality, adhering to PRISMA and AMSTAR guidelines. Results: Our study comprised 38 trials involving 8748 individuals, with 7734 patients undergoing follow-up. The pooled results showed that individuals with DM had an increased incidence of POCD compared to nondiabetic individuals (RR: 1.44, 95% CI: 1.26–1.65). The incidence of POCD was significantly higher in the group of patients with an average age older than 65 years (RR: 1.69, 95% CI: 1.30–2.20) compared with diabetic patients with an average age younger than 65 years (RR: 1.29, 95% CI: 1.09–1.64). Compared with diabetic patients undergoing cardiac surgery (RR: 1.33, 95% CI: 1.15–1.53), patients receiving non-cardiac surgery showed a greater incidence of POCD (RR: 2.01, 95% CI: 1.43–2.84). Conclusion: Current evidence underscores that diabetic patients face a significantly higher risk of POCD compared to their nondiabetic counterparts. Further research is warranted to clarify the precise mechanisms of this relationship and explore potential preventive strategies for diabetic patients.
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